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"Silm\u00e4tautien hoitotakuussa pysyminen on ollut l\u00e4\u00e4k\u00e4riresurssivajeen takia huolena jo useiden vuosien ajan. V\u00e4est\u00f6n ik\u00e4\u00e4ntyess\u00e4 ja silm\u00e4tautien hoidon kehittyminen on lis\u00e4nnyt viime vuosina merkitt\u00e4v\u00e4sti hoidon tarvetta. Omaa l\u00e4\u00e4k\u00e4rity\u00f6voimaa on jatkuvasti ollut vaikea rekrytoida ja sen vuoksi vajetta on t\u00e4ytetty useilla ostosopimuksilla. Nyt yll\u00e4tt\u00e4en l\u00e4\u00e4k\u00e4riresurssi on romahtanut niin pieneksi, ett\u00e4 se muodostaa potilasturvallisuus riskin. Potilaiden hoidosta merkitt\u00e4v\u00e4 osa on hoitotakuun ulkopuolella ja virka-aikaisten l\u00e4\u00e4k\u00e4ripalveluiden varmistaminen on v\u00e4ltt\u00e4m\u00e4t\u00f6nt\u00e4 p\u00e4ivyst\u00e4v\u00e4ss\u00e4 keskussairaalassa. Soite on selvitt\u00e4nyt yhteisty\u00f6mahdollisuuksia Tervian ja er\u00e4iden l\u00e4hisairaanhoitopiirien kanssa, mutta heill\u00e4 ei t\u00e4ss\u00e4 aikataulussa ole mahdollisuutta auttaa tilanteessa.",
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"Soiten on kuitenkin v\u00e4ltt\u00e4m\u00e4t\u00f6nt\u00e4 tuottaa silm\u00e4tautien erikoisalan l\u00e4\u00e4k\u00e4ripalvelut ja vallitsevassa tilanteessa kuntayhtym\u00e4n kyseisten l\u00e4\u00e4k\u00e4ripalveluiden toiminnan turvaaminen edellytt\u00e4\u00e4 suorahankintaa palveluntuottajalta. Muutokset henkil\u00f6st\u00f6resursseissa ovat olleet ennakoimattomia, eik\u00e4 hankintayksikk\u00f6 ole voinut sujuvasti varautua niihin. Ainoaksi vaihtoehdoksi on j\u00e4\u00e4nyt yhteisty\u00f6 yksityissektorin kanssa. Vaihtoehtoisia markkinoilla olevia palveluntuottajia on selvitetty. Tilanne edellytt\u00e4\u00e4 nopeaa ja v\u00e4lit\u00f6nt\u00e4 sopimista. Tiedustelujemme pohjalta olemme saaneet Coronarialta tarjouksen l\u00e4\u00e4k\u00e4ripalveluiden kokonaisulkoistuksesta vuoden 2023 loppuun. Keskeinen merkitt\u00e4v\u00e4 osa Coronarian tarjouksessa on se, ett\u00e4 he sitoutuvat saattamaan kaikki hoitojonot lakis\u00e4\u00e4teiselle tasolle sopimuskauden lopussa. Suorahankinta tehd\u00e4\u00e4n Coronarialta ajanjaksolle 1.9.2022-31.12.2023. Hankinnan ennakoitu arvo on 1 000 000 EUR (alv 0 %). ",
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"officialName": "Markkinaoikeus",
"nationalRegistrationNumber": "",
"department": "",
"nutsCodes": [],
"postalAddress": {
"streetAddress": "S\u00f6rn\u00e4istenkatu 1",
"postalCode": "00580",
"town": "Helsinki",
"country": "FI"
},
"telephoneNumber": "+358 295643300",
"email": "[email protected]",
"contactPerson": "",
"mainUrl": "http:\/\/www.oikeus.fi\/markkinaoikeus",
"validationState": 0
},
"reviewProcedure": [],
"validationState": 2
},
"attachmentInformation": {
"description": [],
"links": [],
"validationState": 2
},
"modifications": {
"mainCpvCode": {
"code": "",
"name": "",
"vocCodes": []
},
"additionalCpvCodes": [],
"nutsCodes": [],
"mainsiteplaceWorksDelivery": [],
"descrProcurement": [],
"timeFrame": {
"type": 0,
"canBeRenewed": false,
"renewalDescription": []
},
"justificationForDurationOverFourYears": [],
"justificationForDurationOverEightYears": [],
"totalValue": {
"currency": ""
},
"awardedToGroupOfEconomicOperators": false,
"contractors": [],
"description": [],
"reason": 0,
"reasonDescriptionEconomic": [],
"reasonDescriptionCircumstances": [],
"increaseBeforeModifications": {
"currency": ""
},
"increaseAfterModifications": {
"currency": ""
},
"validationState": 0
},
"contractAwardsDefence": [],
"hilmaStatistics": {
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},
"annexes": {
"d1": {
"noTenders": false,
"procedureType": 0,
"suppliesManufacturedForResearch": false,
"providedByOnlyParticularOperator": false,
"reasonForNoCompetition": 0,
"extremeUrgency": false,
"additionalDeliveries": false,
"repetitionExisting": false,
"designContestAward": false,
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"justification": [
"Silm\u00e4tautien hoitotakuussa pysyminen on ollut l\u00e4\u00e4k\u00e4riresurssivajeen takia huolena jo useiden vuosien ajan. V\u00e4est\u00f6n ik\u00e4\u00e4ntyess\u00e4 ja silm\u00e4tautien hoidon kehittyminen on lis\u00e4nnyt viime vuosina merkitt\u00e4v\u00e4sti hoidon tarvetta. Omaa l\u00e4\u00e4k\u00e4rity\u00f6voimaa on jatkuvasti ollut vaikea rekrytoida ja sen vuoksi vajetta on t\u00e4ytetty useilla ostosopimuksilla. Nyt yll\u00e4tt\u00e4en l\u00e4\u00e4k\u00e4riresurssi on romahtanut niin pieneksi, ett\u00e4 se muodostaa potilasturvallisuus riskin. Potilaiden hoidosta merkitt\u00e4v\u00e4 osa on hoitotakuun ulkopuolella ja virka-aikaisten l\u00e4\u00e4k\u00e4ripalveluiden varmistaminen on v\u00e4ltt\u00e4m\u00e4t\u00f6nt\u00e4 p\u00e4ivyst\u00e4v\u00e4ss\u00e4 keskussairaalassa. Soite on selvitt\u00e4nyt yhteisty\u00f6mahdollisuuksia Tervia Osaajat Oy:n ja er\u00e4iden l\u00e4hisairaanhoitopiirien kanssa, mutta heill\u00e4 ei t\u00e4ss\u00e4 aikataulussa ole mahdollisuutta auttaa tilanteessa.",
"",
"Soiten on kuitenkin v\u00e4ltt\u00e4m\u00e4t\u00f6nt\u00e4 tuottaa silm\u00e4tautien erikoisalan l\u00e4\u00e4k\u00e4ripalvelut ja vallitsevassa tilanteessa kuntayhtym\u00e4n kyseisten l\u00e4\u00e4k\u00e4ripalveluiden toiminnan turvaaminen edellytt\u00e4\u00e4 suorahankintaa palveluntuottajalta. Muutokset henkil\u00f6st\u00f6resursseissa ovat olleet ennakoimattomia, eik\u00e4 hankintayksikk\u00f6 ole voinut sujuvasti varautua niihin. Ainoaksi vaihtoehdoksi on j\u00e4\u00e4nyt yhteisty\u00f6 yksityissektorin kanssa. Vaihtoehtoisia markkinoilla olevia palveluntuottajia on selvitetty. Tilanne edellytt\u00e4\u00e4 nopeaa ja v\u00e4lit\u00f6nt\u00e4 sopimista. Tiedustelujemme pohjalta olemme saaneet Coronarialta tarjouksen l\u00e4\u00e4k\u00e4ripalveluiden kokonaisulkoistuksesta vuoden 2023 loppuun. Keskeinen merkitt\u00e4v\u00e4 osa Coronarian tarjouksessa on se, ett\u00e4 he sitoutuvat saattamaan kaikki hoitojonot lakis\u00e4\u00e4teiselle tasolle sopimuskauden lopussa. Suorahankinta tehd\u00e4\u00e4n Coronarialta ajanjaksolle 1.9.2022-31.12.2023. Hankinnan ennakoitu arvo on 1 000 000 EUR (alv 0 %). ",
"",
"L\u00e4\u00e4k\u00e4ripalvelun kokonaisulkoistuksen sijaan tavoitteena on edelleen lis\u00e4t\u00e4 virkal\u00e4\u00e4k\u00e4rity\u00f6n osuutta niin, ett\u00e4 erikoisala voitaisiin Soitessa jatkossa hoitaa omana virkal\u00e4\u00e4k\u00e4rity\u00f6n\u00e4. Lis\u00e4ksi kartoitetaan yhteisty\u00f6n mahdollisuutta toisen hyvinvointialueen ja erikoissairaanhoidon yksik\u00f6n kanssa. Valmistelun aikana on selvitetty Tervian mahdollisuus tarjota silm\u00e4l\u00e4\u00e4k\u00e4rity\u00f6panosta Kokkolaan, mutta heill\u00e4 ei ole tarvittavia resursseja k\u00e4ytett\u00e4viss\u00e4\u00e4n silm\u00e4taudeilla. ",
"",
"Suorahankinta perustuu julkisista hankinnoista ja k\u00e4ytt\u00f6oikeussopimuksista annetun lain 40 \u00a7:n 2 mom. 4 kohdan mukaiseen \u00e4\u00e4rimm\u00e4iseen kiireeseen, joka t\u00e4ss\u00e4 tapauksessa liittyy riitt\u00e4v\u00e4st\u00e4 potilasturvallisuuden varmistamiseen. Kyseisen toiminnan alati jatkuvan tarpeen vuoksi hankinnassa ei ole mahdollista noudattaa hankintalaissa asetettuja m\u00e4\u00e4r\u00e4aikoja ilman, ett\u00e4 potilasturvallisuus merkitt\u00e4v\u00e4ll\u00e4 tavalla vaarantuisi. Perustelut suorahankinnan valinnalle ilman ennakkoon julkaistua tarjouskilpailukutsua on kuntayhtym\u00e4n kannalta ennalta arvaamattomista syist\u00e4 aiheutunut \u00e4\u00e4rimm\u00e4inen kiire."
]
},
"d2": {
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"pureResearch": false,
"providedByOnlyParticularOperator": false,
"reasonForNoCompetition": 0,
"extremeUrgency": false,
"additionalDeliveries": false,
"repetitionExisting": false,
"designContestAward": false,
"commodityMarket": false,
"advantageousTerms": false,
"advantageousPurchaseReason": 0,
"bargainPurchase": false,
"justification": []
},
"d3": {
"noTenders": false,
"procedureType": 0,
"otherServices": false,
"productsManufacturedForResearch": false,
"allTenders": false,
"providedByOnlyParticularOperator": false,
"reasonForNoCompetition": 0,
"crisisUrgency": false,
"extremeUrgency": false,
"additionalDeliveries": false,
"repetitionExisting": false,
"commodityMarket": false,
"advantageousTerms": false,
"advantageousPurchaseReason": 0,
"maritimeService": false,
"otherJustification": 0,
"justification": []
},
"d4": {
"noTenders": false,
"providedByOnlyParticularOperator": false,
"reasonForNoCompetition": 0,
"justification": []
},
"directNational": {
"purchaseType": 0,
"justification": []
}
},
"isPrivateSmallValueProcurement": false,
"espdRequestReferences": [],
"hilmaSubmissionDate": "2022-08-29T12:04:12.6116304",
"dateCreated": "2022-08-19T10:03:07.5401153",
"dateModified": "2022-09-02T07:00:06.2760627"
}